Purpura Fulminans Secondary to Streptococcus pneumoniae Meningitis.

Case Reports in Infectious Diseases
Erick F AlvarezMayur S Ramesh

Abstract

Purpura fulminans (PF) is a rare skin disorder with extensive areas of blueblack hemorrhagic necrosis. Patients manifest typical laboratory signs of disseminated intravascular coagulation (DIC). Our case describes a 37-year-old previously healthy man who presented with 3 days of generalized malaise, headache, vomiting, photophobia, and an ecchymotic skin rash. Initial laboratory workup revealed DIC without obvious infectious trigger including unremarkable cerebrospinal fluid (CSF) biochemical analysis. There was further progression of the skin ecchymosis and multiorgan damage consistent with PF. Final CSF cultures revealed Streptococcus pneumoniae. Despite normal initial CSF biochemical analysis, bacterial meningitis should always be considered in patients with otherwise unexplained DIC as this may be an early manifestation of infection. PF is a clinical diagnosis that requires early recognition and prompt empirical treatment, especially, in patients with progressive altered mental status, ecchymotic skin rash, and DIC.

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Citations

Nov 5, 2013·The American Journal of the Medical Sciences·Christine Saraceni, Daniel Schwed-Lustgarten
Feb 16, 2013·Enfermedades infecciosas y microbiología clínica·Angélica Calderón-KomáromySusana Córdoba
Jan 1, 2014·Journal of Medical Case Reports·Hiromichi SuzukiHidenori Nakamura
Oct 22, 2017·BMJ Case Reports·Hock Gin TeoTracy Lee Lyee Ting

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Methods Mentioned

BETA
biopsy

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